The present invention relates to a surgical instrument for stapling and cutting a blood vessel or other organic structure, a method for stapling and cutting, surgical staple clips designed to grip the blood vessel or other organic structure, and a handle for the surgical instrument.
The following patent references show surgical instruments having various features. U.S. Pat. No. 3,675,688 to Bryan describes a surgical tool for ligating, suturing and dividing organic tubular structures in a single unitary operator movement by first capturing the tubular structure in a jaw subassembly which encompasses both the forward exposed side of the tubular structure and the opposing, rearward side of the tubular structure (FIG. 11a, jaw size beta). Thereafter in a single operator stroke, a rod moves rearward with respect to the distal end of the instrument, ligating the organic structure, then firing a pair of staples over the structure (ejecting the staples with a spring force) and cutting the tubular structure with a knife intermediate the staples.
U.S. Pat. No. 3,777,538 to Weatherly discloses a surgical device which applies a singular clip to ligate an organic tubular structure.
U.S. Pat. No. 4,602,629 to Schnirman discloses a combined surgical blade and clip assembly including a pair of opposing platforms, joined together by a spring hinge. The platforms have multiple platform levels. The lowest levels hold clips which, upon depression of the hinge and compression of the low level platform surfaces together, clips legs closed about the tubular organic structure. Thereafter upon further compression of the hinge and opposing platforms, the pair of opposing high level platform surfaces move towards each other. A blade is mounted on at least one high level platform. Upon compression of the high level platforms, the blade cuts the tubular structure. The opposing high level platform has an anvil or a blade sheath to guide the blade. The blade and clip assembly is carried in the jaws of a surgical clamp. The clips, carried on the lower platform levels, are dispensed on the tubular structure and remain thereon after the tube is cut. U.S. Pat. No. 5,104,394 to Knoepfler discloses an automatic stapler which staples or clips and then cuts an organic tubular structure. Upon compression of the operator""handle,jaws carrying a staple clip close at the distal end of the device. If the operator wants to cut an item at the stapled site, he or she moves a thumb slide, located at a remote location on the handle, away from the compressible hand grip. The system dispenses a single staple clip during each operation. U.S. Pat. No. 5,336,229 to Noda discloses a dual stapler or ligating assembly with a surgical blade. In operation, the operator depresses a compressible handle and then depresses a separate trigger to transect the organic tissue. U.S. Pat. No. 5,447,513 to Davison discloses a stapler and surgical blade assembly having a single stapler jaw pair, a blade and blade guide subassembly, angularly displaced with respect to each other at the distal end of the stapler-blade assembly. See FIG. 3. To staple and cut the blood vessel, the operator staples one location on the vessel, moves the distal end of the instrument along the vessel to a second location, dispenses another staple and then maneuvers the blade slide, on the instrument""handle, and cuts the vessel at an intermediate position.
U.S. Pat. No. 3,631,707 to Miller discloses a hemostatic clamp carrying a surgical staple or clip for blood vessels.
The following patent reference shows a surgical handle design: U.S. Pat. No. 5,171,250 to Yoon discloses a handle which the operator must compress to close and dispense a staple clip on an anatomical structure. Prior to compressing the handle, the operator squeezes a trigger then rotates a pivoting lock bar away from the compressible handle. After dispensing the staple, the operator depresses a second compressible handle located at a proximal end above the primary compressible handle.
The following patent references show various clip grip patterns for surgical staples or clips: U.S. Pat. No. 5,192,288 to Thompson discloses in FIG. 11aB a surgical clip with a shallow, longitudinal grove (having a truncated, conical cross-section) and V-shaped cross channels. The vertex of the V channels is directed towards the vertex of the staple clip. U.S. Pat. No. 5,269,792 to Kovac discloses surgical clips in FIGS. 13A, B and C with a longitudinal channel (having a pentagonal, cross-sectional shape) and laterally disposed V channels (also pentagonal). The V channels have vertices directed away from the primary vertex of the staple clip.
U.S. Pat. No. 3,326,216 to Wood shows a large, central channel and cross or lateral channels having an equal depth. U.S. Pat. No. 3,867,944 to Samuels shows longitudinally disposed, peripherally located, protrusions. U.S. Pat. No. 4,188,953 to Klieman shows a clip with flat surface and diagonal channels. U.S. Pat. No. 4,449,530 to Bendel shows a clip with a cross-hatch active surface. U.S. Pat. No. 4,696,396 to Samuels shows clips with centrally aligned protrusions. U.S. Pat. No. 4,844,066 to Stein shows clips with a central, longitudinal channel and lateral cross channels. The longitudinal channel is generally rectilinear. Stein""clip first deforms the fore-ends of clip legs, then closes about tubular organic structure. U.S. Pat. No. 4,971,198 to Mericle shows, in FIG. 6, a clip with a shallow, longitudinal channel and deep cross or lateral channels. The lateral channels are square and deep.
The following patent references show various surgical clips or staple holders: U.S. Pat. No. 3,713,533 to Reimels; U.S. Pat. No. 4,076,120 to Carroll; and U.S. Pat. No. 4,146,130 to Samuels.
It is an object of the present invention to provide a surgical instrument for stapling and cutting a blood vessel or other organic structure in a singular, operative stroke. As used herein the term xe2x80x9cblood vesselxe2x80x9d refers to any anatomical, tubular structure in a mammal. The term xe2x80x9corganic structurexe2x80x9d refers to any anatomical structure in a human or other mammal. Sometimes the term xe2x80x9cblood vesselxe2x80x9d is used as a shorthand reference to both xe2x80x9cblood vesselsxe2x80x9d and xe2x80x9corganic structures.xe2x80x9d
It is another object of the present invention to provide a method for surgically stapling and cutting a blood vessel or other organic structure in a body by simultaneously clipping both sides of a segment of a blood vessel (or other organic structure) and then, in the same, singular, operative stroke, cutting the segment wherein the clipping occurs during an initial portion of the stroke and the cutting occurs during a subsequent portion of the stroke.
It is an additional object of the present invention to provide surgical clips having unique, non-slip, high traction pattern to clamp or clip a blood vessel or other organic structure in the body.
It is an additional object of the present invention to provide a surgical instrument wherein a pair of surgical staple clips are first clamped onto the blood vessel or other organic structure in the body and then, during the single, operative stroke, the blood vessel or organic structure is cut.
It is an another object of the present invention to provide a surgical instrument with clip jaw sets and a scissor jaw set which are actuated at different times based on a single stroke of a cam moving in dissimilar cam follower channels.
It is an additional object of the present invention to provide a surgical instrument wherein a cam pin is retracted and the clip jaw sets first close on the blood vessel and, immediately thereafter, the scissor jaw set cuts the blood vessel or organic structure based upon further retraction of the cam pin. The cam pin moves in the clip-action cam follower channel and the cut-action cam follower channel.
It is an additional object of the present invention to provide a surgical instrument with a compressible handle that retracts a rod carrying the cam pin at the distal end of the rod.
It is another object of the present invention to pivotally mount the clip jaw sets and the scissor jaw set on a common lateral axis at the distal end of an elongated tube within which longitudinally moves an actuator rod.
It is another object of the present invention to provide a method for surgically stapling and cutting a segment of a blood vessel or other organic structure utilizing a retracting rod to simultaneously clip both sides of the blood vessel segment (or other organic structure segment) and then cut the segment during a singular, operative stroke and rod retraction.
It is a further object of the present invention to provide a method utilizing two U-shaped surgical staple clips and simultaneously collapsing both U-shaped clips onto the blood vessel or organic structure segment.
It is another object of the present invention to provide a method wherein the clipping and cutting steps include the step of translating the singular rod retraction into sequential pivotal movement about a common axis at the distal end of the surgical instrument.
It is another object of the present invention to provide a handle for a surgical instrument.
It is a further object of the present invention to provide a handle with a movable handle member having a tactile response surface which abuts a response wall on a stationary handle member.
It is a further object of the present invention to provide the tactical response surface which informs the operator, via tactile sensations, that he or she has moved the handle and has retracted or extended the rod through certain discrete segments thereby signaling to operator that the surgical instrument has clipped and, subsequently, cut the blood vessel or organic structure.
It is another object of the present invention to provide various tactile response surfaces on the movable handle member and different tactile response walls on the stationary handle member.
It is an additional object of the present invention to provide a latch or a ratchet lock on the handle.
It is another object of the present invention to provide a surgical staple clip for use with the surgical instrument.
It is a further object of the present invention to provide a surgical staple clip having a longitudinal center channel on a clip face and X-shaped channels with vertices coextensive with the longitudinal center channel to provide a high degree of traction on the clip face.
It is an additional object of the present invention to provide a surgical staple clip wherein two X-shaped channels are defined on terminal planer facial segments of the clip face.
The surgical instrument for stapling and cutting a blood vessel or other organic structure utilizes surgical staple clips. The surgical instrument includes an elongated tube having a longitudinally movable rod disposed therein. A handle is mounted on the proximal end of the tube. The handle has a movable member which causes the movable rod to longitudinally shift positions in the tube. A pair of surgical staple clip-carrying jaw sets are pivotally mounted on a common lateral axis located at the distal end of the elongated tube. Each clip jaw set includes two jaw members. Each jaw member defines a clip channel at its jaw mouth. The surgical clips reside in the clip channels when the surgical instrument is utilized. A scissor jaw set is disposed intermediate the pair of clip jaw sets and is also pivotally disposed on the same common lateral axis. The surgical instrument includes a laterally extending cam that is mounted on the distal end of the movable rod. The cam, preferably a laterally extending pin, moves within cam follower channels defined in the clip jaw sets and the scissor jaw set. Accordingly, each clip jaw set defines a clip-action cam follower channel and the scissor jaw set defines a cut-action cam follower channel. When the cam moves based upon the longitudinal movement of the rod, the clip jaw sets first clip the blood vessel or other organic structure due to the clip-action cam follower channels. Thereafter, the scissor jaw set closes based upon the longitudinal movement of the cam in the cut-action cam follower channel.
To achieve the sequential clip and then cut-action, the clip-action cam follower channels define different, non-linear channel segments as compared to the cut-action cam follower channel. In a preferred embodiment, the movable rod retracts the cam from the distal end of the elongate tube.
The method for stapling and cutting a blood vessel or other organic structure utilizes an elongated surgical instrument carrying two surgical staple clips at the distal end of the surgical instrument. The method includes the steps of providing a movable rod, coextensive with the elongated surgical instrument, extending from an outboard, proximal position to a distal, surgical site in the body. The method also includes providing two surgical staple clips at the distal end of the rod. The method involves axially retracting said rod in a single, operative stroke, simultaneously clipping both sides of the designated segment of blood vessel or other organic structure with the two surgical staple clips during an initial portion of the stroke, and subsequently cutting the segment or other organic structure during a subsequent portion of the singular, operative stroke. In a preferred embodiment, the method includes simultaneously collapsing U-shaped clips onto the segment. The clipping and subsequent cutting is provided, in a further embodiment, by a singular operative stroke caused by a single, generally uniform, retraction of the rod away from the distal end of the surgical instrument. The clipping and cutting includes, in an enhanced embodiment, the step of translating the singular rod retraction movement into sequential, pivotal movement about a common axis at the distal end of the surgical instrument.
In another embodiment, a handle for a surgical instrument is provided. The handle includes a movable member coupled to a movable rod in an elongated surgical instrument. The handle also includes a stationary grip member mounted to the elongated tube, within which moves the longitudinally movable rod. The movable handle member pivots towards and away from the stationary handle member. The movable member includes a tactile response surface which abuts a response wall on the stationary member. The tactile response surface generates tactile responses to the operator when the movable member pivots towards the stationary member due to interference with the tactile response wall. In one embodiment, the tactile response surface on the movable handle member is an undulated or wavy surface which rides over a generally planar tactile response wall. In another embodiment, the tactile response surface defines a plurality of ridges which ride over a generally planar or other specially shaped tactile response wall. In a further embodiment, the tactile response surface defines a plurality of fine tooth ridges and the tactile response wall includes a complementary, biased fine tooth providing tactile responses upon movement of the movable handle member relative to the stationary handle member.
In a further embodiment of the handle, the tactile response surface and the responsive tactile piece define a ratchet or a latch set. A responsive tactile piece is carried by the stationary handle member and generates tactile responses to the operator when the tactile response surface on the movable handle member translates or moves past the responsive tactile piece. In a further embodiment, the responsive tactile piece is biased towards the tactile response surface. Further, the responsive tactile piece includes an operator control surface to provide a counter force against the biased member which is part of the responsive tactile piece. In other words, the operator moves the biased member by placement of an appropriate force on the control surface against the biasing force which generally directs the biased member towards the tactile response surface on the movable handle member. In a further embodiment, the biased member can be latched in place with respect to the stationary handle member with a latch. In one embodiment, the latch includes a detent and a complementary nub.
The surgical staple clip is utilized for closure of a blood vessel or other organic structure. The surgical staple clip includes a clip face adapted to interface with the blood vessel or other organic structure. The clip face has planar facial segments and a longitudinal center channel. The longitudinal center channel has a triangular cross-section. The clip face includes terminal planar facial segments which further define X-shaped channels with vertices coextensive with the longitudinal center channel. The X-shaped channels also have a triangular cross-section. In a further embodiment, the surgical staple clip includes two X-shaped channels on each terminal planar facial segment.